Franny Jongbloed

178 CHAPTER 7 Table 3. (continued) Parameter Intervention Restricted Diet DER-Diet Control Before After P- Value Before After P- Value Before After P- Value Tyrosine (mmol/L) 0.05 ± 0.003 0.05 ± 0.002 0.08 0.06 ± 0.003 0.06 ± 0.004 0.70 0.06 ± 0.004 0.06 ± 0.003 0.58 Valine (mmol/L) 0.16 ± 0.007 0.13 ± 0.004 0.004 0.19 ± 0.01 0.18 ± 0.007 1.00 0.18 ± 0.01 0.20 ± 0.01 0.17 Changes in metabolic parameters after the dietary intervention groups. Values are depicted as mean ± standard error of the mean. Significant P- values are depicted Italics, while significant p- values after the Bonferroni correction for multiple testing are depicted in bold and Italics. * baseline levels in the restricted diet group are significantly lower than in the DER-diet and control group. This is due to a high percentage of patients with serum albumin levels which lay below the normal values of 35–55 g/L. ** baseline levels in the control group are higher, due to patients with levels of serum insulin of >180 pmol/L. Detailed analysis of HDL-subclasses showed a trend towards a decrease in the medium HDL-particles, while other HDL-subclasses were not affected (data not shown). The DER- diet group had higher free fatty acids after the intervention ( P= 0.01), based on an increase of saturated fatty acids (SFA) ( P= 0.002). Furthermore, the DER-diet resulted in a significant decrease in serum cholesterol ( P= 0.03) Lipoprotein subclasses very small very-low-density- lipoprotein (XS-VLDL), intermediate-density-lipoprotein (IDL) and large low-density- lipoprotein (L-LDL) showed a trend towards a decrease due to the DER-diet, but this did not reach significance (data not shown). Both plasma prealbumin (PAB) (Figure 5A) and plasma retinol binding protein (RBP) (Figure 5B) were significantly lower after the restricted diet compared to levels before starting the diet, decreasing on average 27% ( P= 0.0002) and 22% ( P= 0.001), respectively. All except one patient in the restricted diet group showed a decrease in serum PAB and RBP. The eight patients who did not complete the restricted diet showed an average increase of 10% in PAB (Figure 5C) and 7% in RBP (Figure 5D), which was significantly different than the measures of those who completed the diet. No significant changes were seen in the DER-diet and in the control group in both PAB (Figure 5A) and RBP (Figure 5B).